UnitedHealthcare, Aetna fined by DOBI

UnitedHealthcare and Aetna Health were fined $2.5 million and $350,000, respectively, this year for violating state health insurance laws.UnitedHealthcare and Aetna Health were fined $2.5 million and $350,000, respectively, this year for violating state health insurance laws.

The fines were levied by the state’s Department of Banking and Insurance. UnitedHealthcare and its affiliates, AmeriChoice of New Jersey, Oxford Health Insurance and Oxford Health Plans, were fined in the first quarter for using non-designated providers of hemophilia services for nine months, and for failing to promptly comply with decisions of the state’s Independent Health Care Appeals Program that reverses denials of claims and authorizations for treatment.

Aetna Health was fined in the second quarter for issuing 335 new small employer health plans after notifying DOBI late last year that it was withdrawing from the New Jersey small business market. Health insurers are required to stop issuing new policies after two months of announcing withdrawal from the state.

“The Department investigated and pursued cases on behalf of consumers that resulted in millions of dollars in fines and recoveries in the first half of 2018,” said DOBI Commissioner Marlene Caride. “These actions should send a clear message that the Department takes very seriously its mission to ensure that New Jersey residents are protected and regulated entities are operating in compliance with the law.” Copyright 2018 BridgeTower Media. All Rights Reserved.

CREDIT: Vince Calio